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NPI Code Detail

MEDICARE: MARITZA MENDOZA

MEDICARE: MARITZA MENDOZA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100OTHERI DON'T UNDERSTAND

General Provider Information

NPI Number : 1912610379
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARITZA MENDOZA
Provider Business Mailing Address
First Line : 1710 W KANSAS AVE
Second Line :
City : GARDEN CITY
State : KS
Zip : 67846-4810
Country : US
Telephone Number : 620-295-1744
Fax Number :
Provider Business Practice Location Address
First Line : 1710 W KANSAS AVE
Second Line :
City : GARDEN CITY
State : KS
Zip : 67846-4810
Country : US
Telephone Number : 620-295-1744
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2023
Last Update Date : 01/02/2023

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Directions to “ MARITZA MENDOZA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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